Objective  To summarize clinical characteristics, prevention and treatment of postoperative chronic hyponatremia after liver transplantation (LT).

  Methods  Clinical data of 26 patients presenting with chronic hyponatremia after LT were retrospectively analyzed. Baseline data and main complications of patients with hyponatremia after LT were recorded. The correlation between postoperative length of hospital stay and the duration of hyponatremia was analyzed. Clinical treatment and prognosis were summarized.

  Results  Among 26 patients, the median blood sodium concentration was 131 mmol/L (range 125 to 133 mmol/L). All patients were diagnosed with mild or moderate degree of hyponatremia. Main complications included pulmonary infection (n=13, 50%), acute rejection of liver graft (n=7, 27%) and digestive tract hemorrhage (n=7, 27%). Postoperative length of hospital stay was correlated with the duration of hyponatremia. After full evaluation of patient's condition and excluding the potential inducers, a portion of 3% of hypertonic saline was administered via gastro-intestinal tract and/or vein. After positive treatment, 23 cases (88%) were healed and 3 (12%) died from infection complicated with multiple organ failure.

  Conclusions  After LT, the incidence of chronic hyponatremia is low with mild severity. Postoperative length of hospital stay is correlated with the duration of hyponatremia. The key of treatment is to timely exclude the inducers, correct the low level of sodium based upon the individual principles and prevent the incidence of postoperative complications.